|
OP AV FUSE UPPR ARM CEPHALIC
|
Facility
|
OP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36818
|
| Hospital Charge Code |
1600000639
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$936.47 |
| Max. Negotiated Rate |
$43,244.40 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,657.28
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$936.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$43,244.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42,396.47
|
|
|
OP AV FUSE UPPR ARM CEPHALIC
|
Facility
|
IP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36818
|
| Hospital Charge Code |
1600000639
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,828.64 |
| Max. Negotiated Rate |
$5,828.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
|
|
OP BREAST CAPSULOTOMY
|
Facility
|
OP
|
$31,541.30
|
|
|
Service Code
|
HCPCS 19370
|
| Hospital Charge Code |
16000789
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$760.15 |
| Max. Negotiated Rate |
$16,791.02 |
| Rate for Payer: Aetna Commercial |
$12,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$15,071.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,651.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,791.02
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: Cigna Medicare Advantage |
$4,651.64
|
| Rate for Payer: Clover Medicare Advantage |
$4,419.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,954.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,791.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,651.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,462.39
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,731.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$760.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$835.84
|
|
|
OP BREAST CAPSULOTOMY
|
Facility
|
IP
|
$31,541.30
|
|
|
Service Code
|
HCPCS 19370
|
| Hospital Charge Code |
16000789
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,731.19 |
| Max. Negotiated Rate |
$4,731.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,731.19
|
|
|
OPD INDIVID NON MD 20-30 MIN
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
HCPCS 90832
|
| Hospital Charge Code |
87504015
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
|
|
OPD INDIVID NON MD 20-30 MIN
|
Facility
|
OP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90832
|
| Hospital Charge Code |
84310060
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$31.23 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$388.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$71.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.34
|
|
|
OPD INDIVID NON MD 20-30 MIN
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
HCPCS 90832
|
| Hospital Charge Code |
87504015
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$115.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$71.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.29
|
|
|
OPD INDIVID NON MD 20-30 MIN
|
Facility
|
IP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90832
|
| Hospital Charge Code |
84310060
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$194.40 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
|
|
OPD INDIVID NON MD 45-50 MIN
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
87504025
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.26
|
|
|
OPD INDIVID NON MD 45-50 MIN
|
Facility
|
OP
|
$1,423.80
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
84310070
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$34.31 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$427.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.57
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$37.73
|
|
|
OPD INDIVID NON MD 45-50 MIN
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
87504025
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
OPD INDIVID NON MD 45-50 MIN
|
Facility
|
IP
|
$1,423.80
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
84310070
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$213.57 |
| Max. Negotiated Rate |
$213.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$213.57
|
|
|
OPD INDIVIDUAL MD 20-30MIN
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
HCPCS 90805
|
| Hospital Charge Code |
84310020
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.50
|
|
|
OPD INDIVIDUAL MD 20-30MIN
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
HCPCS 90805
|
| Hospital Charge Code |
84310020
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$365.00 |
| Rate for Payer: Aetna Commercial |
$277.40
|
| Rate for Payer: Aetna Medicare Advantage |
$219.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$186.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$186.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$186.15
|
| Rate for Payer: Cigna Commercial |
$365.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.34
|
|
|
OPD PLAY TX NON MD 20-30 MIN
|
Facility
|
IP
|
$491.00
|
|
|
Service Code
|
HCPCS 90810
|
| Hospital Charge Code |
84310030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$73.65 |
| Max. Negotiated Rate |
$73.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.65
|
|
|
OPD PLAY TX NON MD 20-30 MIN
|
Facility
|
OP
|
$491.00
|
|
|
Service Code
|
HCPCS 90810
|
| Hospital Charge Code |
84310030
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$11.83 |
| Max. Negotiated Rate |
$245.50 |
| Rate for Payer: Aetna Commercial |
$186.58
|
| Rate for Payer: Aetna Medicare Advantage |
$147.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$125.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$125.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$125.20
|
| Rate for Payer: Cigna Commercial |
$245.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$147.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.01
|
|
|
OPD PSYCHIATRIC EVALUATION
|
Facility
|
OP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90801
|
| Hospital Charge Code |
84310010
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$31.23 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Aetna Medicare Advantage |
$388.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$330.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$330.48
|
| Rate for Payer: Cigna Commercial |
$648.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$388.80
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.34
|
|
|
OPD PSYCHIATRIC EVALUATION
|
Facility
|
IP
|
$1,296.00
|
|
|
Service Code
|
HCPCS 90801
|
| Hospital Charge Code |
84310010
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$194.40 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.40
|
|
|
OPEN ANKLE JNT FUSION
|
Facility
|
IP
|
$77,285.80
|
|
|
Service Code
|
HCPCS 27870
|
| Hospital Charge Code |
1600000297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,592.87 |
| Max. Negotiated Rate |
$11,592.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,592.87
|
|
|
OPEN ANKLE JNT FUSION
|
Facility
|
OP
|
$77,285.80
|
|
|
Service Code
|
HCPCS 27870
|
| Hospital Charge Code |
1600000297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,626.00 |
| Max. Negotiated Rate |
$55,057.64 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55,057.64
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23,185.74
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,592.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,862.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,048.07
|
|
|
OPEN BOWEL TO SKIN
|
Facility
|
IP
|
$12,361.00
|
|
|
Service Code
|
HCPCS 44300
|
| Hospital Charge Code |
1600000634
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,854.15 |
| Max. Negotiated Rate |
$1,854.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,854.15
|
|
|
OPEN BOWEL TO SKIN
|
Facility
|
OP
|
$12,361.00
|
|
|
Service Code
|
HCPCS 44300
|
| Hospital Charge Code |
1600000634
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$297.90 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,708.30
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,854.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$297.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$327.57
|
|
|
OPEN BX/EXC INGUINOFEM NODES
|
Facility
|
IP
|
$18,038.36
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
160000223
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,705.75 |
| Max. Negotiated Rate |
$2,705.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,705.75
|
|
|
OPEN BX/EXC INGUINOFEM NODES
|
Facility
|
OP
|
$18,038.36
|
|
|
Service Code
|
HCPCS 38531
|
| Hospital Charge Code |
160000223
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$434.72 |
| Max. Negotiated Rate |
$16,791.02 |
| Rate for Payer: Aetna Commercial |
$12,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$15,071.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,651.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,791.02
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: Cigna Medicare Advantage |
$4,651.64
|
| Rate for Payer: Clover Medicare Advantage |
$4,419.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,954.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,791.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,651.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,411.51
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,705.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$434.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$478.02
|
|
|
OPEN BX/EXC LN; INT MAMM NODE(
|
Facility
|
OP
|
$15,259.20
|
|
|
Service Code
|
HCPCS 38530
|
| Hospital Charge Code |
16000957
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$367.75 |
| Max. Negotiated Rate |
$16,791.02 |
| Rate for Payer: Aetna Commercial |
$12,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$15,071.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,791.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,651.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,016.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,791.02
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: Cigna Medicare Advantage |
$4,651.64
|
| Rate for Payer: Clover Medicare Advantage |
$4,419.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,954.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,791.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,651.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,577.76
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,288.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$367.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$404.37
|
|
